MEDICARE: YES DENTAL, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	28721	TX

General Provider Information

NPI Number	:	1225573868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YES DENTAL, PLLC

Provider Business Mailing Address
First Line	:	14215 COIT RD
Second Line	:	#112
City	:	DALLAS
State	:	TX
Zip	:	75254-2800
Country	:	US
Telephone Number	:	972-701-8282
Fax Number	:	972-701-8284

Provider Business Practice Location Address
First Line	:	3625 E LOOP 820 S
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76119-1822
Country	:	US
Telephone Number	:	972-701-8282
Fax Number	:	972-701-8284

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KATI NGUYEN YOON
Credential	:	DDS
Telephone Number	:	972-701-8282

Provider Enumeration Date	:	01/05/2017
Last Update Date	:	01/09/2017

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